Neurology & Pain Management Coding Alert

Reader Question:

Stick to 1 Line Item of 64421

Question: Our pain management specialist administered intercostal blocks at T8, T9, T10, and T11. He reported 64421 x 4. Is this correct?

North Dakota Subscriber

Answer: No, your physician is reporting the injections with too many units of service. The descriptor for code 64421 (Injection, anesthetic agent; intercostal nerves, multiple, regional block) notes "multiple, regional block." The code is based on injections of 2 or more intercostal nerves and would be reported with a maximum of 1 unit of service. Therefore, you should only report 64421 one time.